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POC (Intervention - PT intervention decreases hospital readmission in…
POC
Intervention - PT intervention decreases hospital readmission in older adults with pneumonia (Kim, et al., 2015)
Patient Education
Smoking cessation
Decrease rate of mortality
Maintain health of the lungs
Decrease chances of cardiac events
Decrease chances of additional comorbidities
(Edwards, 2004)
Early Mobilization
Shorter duration of delirium and more ventilator-free days (Brahmbhatt , Murugan, & Milbrandt, 2010)
PROM, command following, AROM, transfer training, standing and ambulation administered daily, decreased mortality before discharge in patients with acute respiratory failure. (Morris et al., 2008)
Shorter length of stay (Morris et al., 2008)
Range of Motion
Passive/Active Assisted
Glenohumeral flexion, elbow flexion/extension, wrist flexion/extension, finger flexion/extension, hip flexion, knee flexion/extension, and ankle dorsiflexion/plantarflexion (Mark et al. 2010)
Early physical therapy is feasible from the onset of mechanical ventilation despite high illness acuity and presence of life support devices (Mark et al, 2010)
Chest PT
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Improve mucus transport
Postural drainage
Improve airway clearance
(Schans, 2007)
Improved tidal volume, expiratory reserve volume and VO2 with percussion and postural drainage of lower lobe (Leelarungrayub et al., 2016)
Improved VO2 and VCO2 with percussion and postural drainage of middle lobe (Leelarungrayub et al., 2016)
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Implement PUMP Steps
Begin with HOB 45 degrees of elevation and progress to HOB elevated to 65 degrees plus leg in full dependent position and after standing transfer bed <> chair 2-3x tolerated, progress to ambulation with device. Monitor vitals throughout. (Titsworth, et al 2012)
Reductions in LOS and hospital-acquired infections (Titsworth, et al, 2012)
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Outcome Measures
6 Min Walk
Patients with PNA that experience desaturation during 6MWT have a fourfold increase in mortality (Lama et al., 2003)
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Katz Activities of Daily Living Scale (Kim, et al., 2015)
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Hospital Course
Pt experienced difficulty breathing, productive cough, fever and chills
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